New PDF release: Basic Sciences for Obstetrics and Gynaecology

By Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP, PhD (auth.)

ISBN-10: 1447133277

ISBN-13: 9781447133278

ISBN-10: 3540162143

ISBN-13: 9783540162148

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Sample text

The genital branch of the genitofemoral nerve (L-l, L-2) passes through the inguinal canal (accompanying the round ligament) to supply the labia majora and mons pubis. The pudendal nerve (S-2 to S-4) leaves the pelvis through the greater sciatic foramen, passes through the lesser sciatic foramen into the pudendal canal and supplies the skin of the anus and external anal sphincter (inferior rectal nerve), the lower third of the vagina and the labia, the clitoris, the cavernous muscles, the external urethral sphincter and the anterior part of the levator ani.

It is 12 cm long and passes through the broad ligament to the lateral wall of the pelvis where it crosses the psoas and external iliac vessels. It hooks round the inferior epigastic arteries to the deep inguinal ring, passes through the inguinal canal and fans out into the labium majus. It is composed mainly of fibrous tissue with some smooth muscle at the uterine end and some striated muscle at the labial end. Ligaments Formed from Pelvic Fascia The connective tissue covering the levator ani is condensed into musculofibrous bands in three areas: (a) the transverse cervical ligament (cardinal ligament) arising from the arcuate line on the side wall of the pelvis; (b) the pubocervical ligaments arising from fascia over the pubic bone and passing around the bladder neck; and (c) the uterosacral ligaments (posterior part of the cardinal ligaments) arising from the sacral'promootory.

The arterial supply comes from the arterial rete of the labia majora and from the dorsal artery of the clitoris. The venous plexus drains to the labia majora and to the perineal, vaginal, inferior haemorrhoidal and clitoral veins. 2. 2. ,.... pos):eriorly to rectal lymphatic plexus -'> The Vagina 37 The Clitoris The clitoris consists of two small erectile cavernous bodies terminating in a glans consisting of erectile tissue covered by the prepuce. It is attached to the pubic arch by a suspensory ligament and is covered by stratified squamous epithelium with numerous sweat and sebaceous glands except on the glans itself.

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Basic Sciences for Obstetrics and Gynaecology by Tim Chard MD, FRCOG, Richard Lilford MB, BCh, MRCOG, MRCP, PhD (auth.)

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